Climate change and health: a 2-week course for medical students to inspire change
Authors: Erlend Tuseth Aasheim, Anand Singh Bhopal, Karen O'Brien, Anne Kveim Lie, Espen Rostrup Nakstad, Lene Frost Andersen, Dag Olav Hessen, Bjørn Hallvard Samset, Dan Banik
Journal: The Lancet Planetary Health (2023)

The COVID-19 pandemic has shown not only how life on our planet is closely connected, enabling a zoonotic disease to spread rapidly across human societies worldwide, but also how public health concerns can make societies take unprecedented, fast, and decisive action. Climate change is the single biggest health threat facing humanity,1WHOClimate change – the biggest health threat facing humanity.https://www.who.int/news-room/fact-sheets/detail/climate-change-and-healthDate: 2021Date accessed: February 28, 2022Google Scholar with each fraction of a degree of warming having additional costs for health and global development. Although a reduction of greenhouse gas emissions in line with current global ambitions will lessen these adverse consequences, this will require a large-scale collective response across all sectors. The educational sector plays a pivotal role in harnessing both intersectoral and integrated responses, and in providing a shared platform for understanding what needs to be done to address climate change and achieve the Sustainable Development Goals. 2UNESCOKnowledge-driven actions: transforming higher education for global sustainability. Independent Expert Group on the Universities and the 2030 Agenda.https://unesdoc.unesco.org/ark:/48223/pf0000380519Date: 2022Date accessed: February 28, 2022Google Scholar, 3Shaw E Walpole S McLean M et al.AMEE consensus statement: planetary health and education for sustainable healthcare.Med Teach. 2021; 43: 272-286Crossref PubMed Scopus (99) Google Scholar, 4Kotcher J Maibach E Miller J et al.Views of health professionals on climate change and health: a multinational survey study.Lancet Planet Health. 2021; 5: e316-e323Summary Full Text Full Text PDF PubMed Scopus (105) Google Scholar, 5Omrani OE Dafallah A Paniello Castillo B et al.Envisioning planetary health in every medical curriculum: An international medical student organization's perspective.Med Teach. 2020; 42: 1107-1111Crossref PubMed Scopus (71) Google Scholar, 6Brown A Education for planetary health: a call for papers.Lancet Planet Health. 2021; 5: e762Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar, 7Chase H Hampshire K Tun S Improving the medical curriculum on planetary health and sustainable healthcare.BMJ. 2022; 376: o209Crossref PubMed Scopus (12) Google Scholar In 2022, the key question is not, can we make progress?, but can we make progress fast enough? Still, there are few examples of integrative cross-disciplinary learning approaches to help foster both individual and collective agency for change in the health sector. Here we describe a 2-week elective course on climate change and health in a planetary perspective, delivered to third-year medical students at the University of Oslo in 2022. Our overarching aim was to help students develop a nuanced understanding of how they can use health arguments8WHOCOP26 Special Report on Climate Change and Health: The Health Argument for Climate Action.https://www.who.int/publications/i/item/cop26-special-reportDate: 2021Date accessed: January 28, 2022Google Scholar to convey the urgency of climate action and raise awareness of the roles that health-care systems and health professionals can play to protect health and stay within sustainable planetary boundaries. A complete list of learning objectives (knowledge, competencies, and skills) for the course can be found in the appendix (p 1). The course schedule includes three main modes of learning (table): lectures and discussions on major topics related to climate change and health; workshops with stakeholders who showcase real-life activities within the climate-health linkage; and student-led group work on a chosen topic in which the aim is to identify key messages and discuss how these messages can be delivered to an identified target audience and inspire change.TableSchedule for a 2-week course on climate change and health for medical studentsDay 1Day 2Day 3Day 4Day 5Day 6Day 7Day 8Day 9Day 1009–11 h: Lecture on key themeCourse introduction, health consequences of climate changeClimate changeManaging health care's climate footprintClimate change, biodiversity loss and healthFood and climate changeTransforming societyChange agency in the health sectorSocial and economic sustainabilityCommunication for public healthCourse exam: Groups present their workTeacherMedical doctorPhysicistMedical doctorBiologistDietitianHuman GeographerMedical doctorPolitical scientistMedical doctor..12–14 h: Group workIntroduction and group assignmentGroup workGroup workGroup workGroups present chosen topicGroup workGroup workGroup workGroups hand in presentationsCourse evaluationSupervisorMedical doctor, political scientistMedical doctor, political scientistMedical doctorMedical doctor, political scientistMedical doctorMedical doctor, political scientistMedical doctorMedical doctorMedical doctorMedical doctor, political scientist15–1530 h: WorkshopNational survey on climate change and health in medical curriculaGreen choosing wiselyNational survey of anaesthesiologists and anaesthetic nurses on sustainable anaesthetic practiceNorwegian Physicians Against Climate ChangeHealthcare Without Harm EuropeClimate change and living conditions for Sami people in NorwayDoctors Without BordersWork on climate and environment at the Regional health authorityWork on climate and environment at the hospital level..Presenter–stakeholderMedical studentMedical studentMedical studentMedical doctorNursePsychologist of Sami backgroundMedical doctorHealth, safety and environment advisorEnvironmental lead, University hospital..17–19 h: Social event..............Pizza night for students and teachers.... Open table in a new tab Lectures in week 1 focused on the knowledge base for action, covering "Introduction to climate change and health"; "Climate science"; "Managing healthcare's climate footprint"; "Biodiversity and health"; and "Food systems". Lectures in week 2 focused on action implementation, covering "Societal transformation"; "Change agency in the health sector"; "The 2030 Sustainable development agenda"; and "Effective public health communication". Interdisciplinarity was a prominent feature, with about half of the lectures given by teachers with a medical background and the remainder representing the natural sciences, social sciences, and humanities. Workshops showcased various examples of real-life activities by diverse stakeholders (medical students, activists, international organisations, indigenous communities, and hospitals at regional and local levels). Stakeholders presented their work for 15 min and this was followed by questions, comments, and dialogue. The format was intended to encourage open-mindedness towards integrating different types of knowledge and to illustrate varied ways of working within climate change and health. Group work was student-led. One or two supervisors were available to clarify tasks, discuss options on how to proceed, offer insights on current debates and relevant literature, and facilitate contact with experts or policy makers within their chosen topic. Students identified key messages, a target audience, and a channel for communication; with different groups making diverse choices (appendix p 2). The groups presented their work in class on the last day of the course, followed by a brief discussion between students and teachers. The presentations formed the basis for the course examination (for assessment criteria, see appendix p 2). One of the groups had their work accepted as an op-ed in a newspaper before the course ended.9Dæhlen JH Misje R Ta tak i klimakrisen!.Dagens Medisin. Feb 18, 2022; ([in Norwegian].)https://www.dagensmedisin.no/artikler/2022/02/18/ta-tak-i-klimakrisen/Date: 2022Date accessed: February 28, 2022Google Scholar A post-course evaluation showed that the course had provided students with knowledge and skills thus far not provided in the medical curriculum (appendix p 3). In qualitative written feedback, students reacted positively to the inclusion of a diverse group of lecturers with varying perspectives and backgrounds, and ample time allocated for discussions and group work. Some students signalled an interest for more lectures in the course. They expressed an interest in tools to estimate the carbon footprint of health care, sustainable quality improvement, and health service adaptation to climate change. The course was developed in consultation with medical students with a special interest in climate change and sustainability issues, at a centre dedicated to help implement the Sustainable Development Goals.10Centre for Sustainable Healthcare EducationFaculty of Medicine, University of Oslo.https://www.med.uio.no/she/english/Date: 2022Date accessed: February 28, 2022Google Scholar At the University of Oslo, third-year medical students can choose between different elective course modules. This, alongside the university's strategic focus on sustainable development and climate change, made it possible to develop a 2-week course from the ground up. Although the original plan was in-person teaching, the course was delivered online owing to pandemic restrictions. Given the online delivery, it was easier to record lectures and workshops as a resource for future online learning modules; we are also considering the establishment of alumni groups, coordination with student bursaries, and facilitation of events that showcase student work. Medical faculties in Norway have committed to increase teaching on climate change for all students.11Lie AK Andersen LF Asdal K et al.Klima og bærekraft i helseutdanningene. Rapport 2021. Centre for Sustainable Healthcare Education, University of Oslo, 2022rapport_arbeidsgruppe-for-klima-og-berekraft-i-helseutdanningene.pdfDate accessed: February 28, 2022Google Scholar An elective course can provide additional perspectives for students with a special interest in the interface between climate change and health. On the basis of student examination performance and course evaluation, we conclude that the participants have developed a more nuanced understanding of the linkage between climate and health, in line with the aim of the course. In our experience, lectures encompassing diverse academic perspectives, dialogue with a mix of voices from across the health sector, and communication-oriented group work served as a useful platform for an undergraduate course in planetary health. We declare no competing interests. Download .pdf (.17 MB) Help with pdf files Supplementary appendix